| NPI | 1992347439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0134379) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT028115) |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2022-02-14 |